Robert Whitfield MD explains how bacteria and fungi reach implants through the bloodstream after minor skin breaks. A triathlete contracted waterborne fungi from barefoot running after swimming; another patient got Acinetobacter from soil during Spartan racing. PCR testing catches infections that standard culture tests miss.
We all think about, you know, infections. A cold, a urinary tract infection, a colitis, something that gives bacteria to our own bloodstream, and then that seats itself on whether it's a knee, hip or breast implant. That's. That's the common teaching, you know, for clinicians. But in this case, it was like. It's like being on Episode House, like, so the triathlete now has four types of fungus and multiple types of bacteria. And so I had to start looking up some of these because I didn't recognize some of the fungus. And they're all consistent with water. And so if you think about how this would happen, a triathlete swims, gets out of the water and runs. Many of them run barefoot. And you get little micropunctures in your foot or your foot's cold because the water's cold, you can't feel things. You get a little puncture. It's easy to see how you get a bloodborne contaminant this way that then will subsequently end up in a joint or in an implant and cause a inflammation infection. And so for her, it made a lot of sense to me. Conveniently, about two weeks later, I had a patient show up with a report after an explant that had Acinetobacter. And so for those who don't know what Acinetobacter is, it's a bacteria commonly found infecting severely burned patients or immunocompromised patients. My experience, having done burns for a large portion of my career, I most commonly saw it in burn patients. Nobody's sicker than a severely burned patient. Really, really challenged nutritionally. Skin envelopes damage has to go. Have, you know, their skin excise, it's been burned, replaced with cadaver skin temporarily before they can skin grafted. They develop infections because the immune systems severely compromised the integument or our skin, which protects us from infections severely compromised. So I asked this client of mine, like, what was she doing that she could have possibly got asked neato back? I'm like, were you gardening or digging in soil or what exactly were you doing? And she said, well, I just stay at home or stay at home, mom. And I was like, okay, would you have been in mud for any reason? And she says, oh, I used to do Spartan racing. And well, there you have it. So this is a soil bacteria. It gets under your nails or once again, you puncture in your hand, it contaminates you. And this is how you get it into your bloodstream. And it affects your, like I said, your joint or your your whether it's a knee, a hip, or a breast implant. So these all made sense now. And we have never known these things without using PCR testing, because regular lab testing, you would get in, like I mentioned, a CLIA based lab like Quest or LabCorp, some of these other places, CPL in Austin, they're not performing PCR testing. It's just a swab and a growth on auger plates. And that's traditional. So, you know, having made these inroads with PCR testing to, you know, as definitively diagnose something as possible is giving me great comfort. So when I see these reports, I'm like, well, this is basically why you're having your problems. And then it's not the end of the story. But for that portion, we can help close that chapter.
